RATIONALE: The relationship between airway inflammation and obesity in severe asthma is poorly understood. OBJECTIVES: We sought to determine the relationship between sputum mediator profiles and the distribution of eosinophilic inflammation and obesity in people with severe asthma. METHODS: Clinical parameters and eight mediators in sputum were assessed in 131 subjects with severe asthma from a single center categorized into lean, overweight, and obese groups defined by their body mass index. In an independent group of people with severe asthma (n = 45) and healthy control subjects (n = 19) eosinophilic inflammation was enumerated in bronchial submucosa, blood, and sputum and related to their body mass index. MEASUREMENTS AND MAIN RESULTS: Sputum IL-5 geometric mean (95% confidence interval) (pg/ml) was elevated in the obese (1.8 [1.2-2.6]) compared with overweight (1.1 [0.8-1.3]; P = 0.025) and lean (0.9 [0.6-1.2]; P = 0.018) subjects with asthma and was correlated with body mass index (r = 0.29; P < 0.001). There was no relationship among body mass index, the sputum cell count, or other sputum mediators. In the bronchoscopy group the submucosal eosinophil number in the subjects with asthma was correlated with body mass index (Spearman rank correlation, rs = 0.38; P = 0.013) and the median (interquartile range) number of submucosal eosinophils was increased in obese (19.4 [11.8-31.2]) (cells per square millimeter) versus lean subjects (8.2 [5.4-14.6]) (P = 0.006). There was no significant association between sputum or peripheral blood eosinophil counts and body mass index. CONCLUSIONS: Sputum IL-5 and submucosal eosinophils, but not sputum eosinophils, are elevated in obese people with severe asthma. Whether specific antieosinophilic therapy is beneficial, or improved diet and lifestyle in obese asthma has antiinflammatory effects beyond weight reduction, requires further study.
RATIONALE: The relationship between airway inflammation and obesity in severe asthma is poorly understood. OBJECTIVES: We sought to determine the relationship between sputum mediator profiles and the distribution of eosinophilic inflammation and obesity in people with severe asthma. METHODS: Clinical parameters and eight mediators in sputum were assessed in 131 subjects with severe asthma from a single center categorized into lean, overweight, and obese groups defined by their body mass index. In an independent group of people with severe asthma (n = 45) and healthy control subjects (n = 19) eosinophilic inflammation was enumerated in bronchial submucosa, blood, and sputum and related to their body mass index. MEASUREMENTS AND MAIN RESULTS: Sputum IL-5 geometric mean (95% confidence interval) (pg/ml) was elevated in the obese (1.8 [1.2-2.6]) compared with overweight (1.1 [0.8-1.3]; P = 0.025) and lean (0.9 [0.6-1.2]; P = 0.018) subjects with asthma and was correlated with body mass index (r = 0.29; P < 0.001). There was no relationship among body mass index, the sputum cell count, or other sputum mediators. In the bronchoscopy group the submucosal eosinophil number in the subjects with asthma was correlated with body mass index (Spearman rank correlation, rs = 0.38; P = 0.013) and the median (interquartile range) number of submucosal eosinophils was increased in obese (19.4 [11.8-31.2]) (cells per square millimeter) versus lean subjects (8.2 [5.4-14.6]) (P = 0.006). There was no significant association between sputum or peripheral blood eosinophil counts and body mass index. CONCLUSIONS: Sputum IL-5 and submucosal eosinophils, but not sputum eosinophils, are elevated in obese people with severe asthma. Whether specific antieosinophilic therapy is beneficial, or improved diet and lifestyle in obese asthma has antiinflammatory effects beyond weight reduction, requires further study.
Authors: Allan R Brasier; Sundar Victor; Gary Boetticher; Hyunsu Ju; Chang Lee; Eugene R Bleecker; Mario Castro; William W Busse; William J Calhoun Journal: J Allergy Clin Immunol Date: 2008-01 Impact factor: 10.793
Authors: Abu R Vasudevan; Huaizhu Wu; Antonios M Xydakis; Peter H Jones; E O'Brian Smith; John F Sweeney; David B Corry; Christie M Ballantyne Journal: J Clin Endocrinol Metab Date: 2005-11-01 Impact factor: 5.958
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Authors: Fernando Holguin; Suzy A A Comhair; Stanley L Hazen; Robert W Powers; Sumita S Khatri; Eugene R Bleecker; William W Busse; William J Calhoun; Mario Castro; Anne M Fitzpatrick; Benjamin Gaston; Elliot Israel; Nizar N Jarjour; Wendy C Moore; Stephen P Peters; W Gerald Teague; Kian Fan Chung; Serpil C Erzurum; Sally E Wenzel Journal: Am J Respir Crit Care Med Date: 2012-11-29 Impact factor: 21.405
Authors: Jean Bousquet; Eva Mantzouranis; Alvaro A Cruz; Nadia Aït-Khaled; Carlos E Baena-Cagnani; Eugene R Bleecker; Chris E Brightling; Peter Burney; Andrew Bush; William W Busse; Thomas B Casale; Moira Chan-Yeung; Rongchang Chen; Badrul Chowdhury; Kian Fan Chung; Ronald Dahl; Jeffrey M Drazen; Leonardo M Fabbri; Stephen T Holgate; Francine Kauffmann; Tari Haahtela; Nikolaï Khaltaev; James P Kiley; Mohammad R Masjedi; Yousser Mohammad; Paul O'Byrne; Martyn R Partridge; Klaus F Rabe; Alkis Togias; Christiaan van Weel; Sally Wenzel; Nanshan Zhong; Torsten Zuberbier Journal: J Allergy Clin Immunol Date: 2010-11 Impact factor: 10.793